Treatment Adult ADHD: A Simple Definition
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Adult ADHD and Comorbid Disorders
Many adults with ADHD also suffer from comorbid conditions like major depression (Kessler and colleagues, 2006). Many people who suffer from depression are not able to respond well to medications and may benefit from therapy.
Medications that most effectively improve the symptoms of ADHD appear to increase and balance levels of specific neurotransmitters, which are brain chemicals. The stimulants methylphenidate and amphetamine are frequently prescribed.
Medicines
Many of the medications used to treat ADHD in children can be used in adults. The dosages and effects can be different. The doctor will take a look at the medical history, the family health history, and other medical factors of the individual to determine which drug is the best for them.
The most common ADHD medication is a stimulant. It works by adjusting the levels of norepinephrine, and dopamine in the brain. The stimulants methylphenidate and dextroamphetamine (commonly known as Adderall) increase the availability of these neurotransmitters, which can improve focus and decrease aggression and impulsivity. They come in various forms such as chewable tablets, liquids and skin patches. These stimulants that last longer are popular as they lead to better patient compliance, and more consistent, long-lasting improvement of symptoms.
It is crucial to keep in mind that co-occurring disorders like depression or anxiety disorders can affect the response to ADHD medication. Therefore, it is recommended that psychiatric disorders be treated first, and medication used as secondary measure. The medications that can be used to treat comorbid disorders of mood are atomoxetine (Bupropion) tricyclic antidepressants and bupropion (Wilens, 2004).
Some patients may experience a "rebound effect" in which their ADHD symptoms worsen after discontinuing stimulant medication. In these instances, a brief trial of a lower dose of stimulant medication can be helpful.
Some people are unable to tolerate stimulant medicines or are not able to take them due to drug abuse or other health issues, like heart issues that are severe or hypertension. In these instances, non-stimulant medications like atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications don't have the same negative side effects as stimulants, and are less likely to be abused or misused.
Psychotherapy
People suffering from ADHD are able to benefit from psychotherapy (talk therapy). It can help them develop strategies to improve their lives manage anxiety and stress, resolve conflicts, and cope with problems in relationships and at work. It can also assist with people with mental disorders that coexist, like depression and addiction disorders.
Talk therapies include cognitive-behavioral therapy (CBT) as well as mindfulness-based cognitive therapy, and schema therapy. These therapies are based on the belief that one's beliefs and thoughts influence how they think, feel and behave. CBT helps an individual identify negative thoughts and behaviors and then devise and implement strategies to change these. Mindfulness-based cognitive therapy uses techniques for meditation to teach a person how to focus on their emotions and thoughts, manage their impulses and improve their executive functioning. Schema therapy and other forms of psychotherapy focused on a person's history with their family may be useful for people who suffer from ADHD who have significant secondary issues.
In addition to medication, psychotherapy can help address the specific issues that arise from ADHD like difficulty staying on track with schoolwork, resolving conflicts, getting along with others, ignoring important dates or responsibilities, and impulsive decisions that result in legal or financial problems. It can also assist individuals to address and resolve issues that cause ADHD symptoms, such as depression or anxiety.
Psychotherapy can help people discover healthy coping techniques and reduce stress. For example exercising, improving sleep and healthy eating habits. It can also offer support to the family member or spouse who is struggling with the effects ADHD affects their relationship. Therapy for families and marriage can help families and couples communicate better and understand how to manage ADHD symptoms together.
Cognitive Behavioral Therapy (CBT)
CBT is a type of psychotherapy that is focused on transforming the negative patterns of thinking that clients have. It involves a dialogue based on skills with a mental health professional to identify the root causes of the symptoms. This treatment is designed to assist clients overcome their difficulties and develop coping skills that are compatible with their everyday lives.
Therapists who specialize in adult ADHD-CBT instruct clients to recognize unhelpful thoughts and help them learn to replace them with more productive thoughts. This process can take a long time. However, it's a good option for adults who do not receive enough relief from medications.
A recent RCT study concluded that when paired with medication, CBT is superior to CBT on its own in improving the core symptoms, emotional symptoms, self-esteem and social functioning of adults suffering from ADHD (Clarke et al. 2017). CBT when combined with methylphenidate may be particularly effective for people with more serious underlying issues.
Therapists who provide this type of treatment work with clients to devise an action plan to address their specific problems. They teach them a set of practical skills that are simple to master and have a high chance of success. Charts are typically utilized to track progress and reward positive behaviors. This might include a daily report for a child that outlines the tasks they are required to finish at school or the positive behaviors that need to be exhibited, and an approach to recording and rewarding rewards. The therapists can also discuss the possibility that negative consequences may be introduced when a child fails to complete their tasks. This can be done in a very sensitive and supportive way.
Metacognitive Therapy
Metacognitive therapy is an innovative kind of psychotherapy that helps people change their thinking. This kind of therapy can be effective for people suffering from a range of mental health problems, including depression. It is a form of cognitive behavior therapy that helps people recognize negative thinking patterns and their effect on their emotions. This kind of therapy can help to develop mental tools that are flexible and useful.
This study was designed to investigate the relationship between metacognitive capabilities and daily functioning among adults with ADHD. To achieve this, we examined the relationship between the self- and informant-rated impairments in daily functioning to the indicators of metacognition (comprehensive knowledge, regulation of cognition, debugging, management of information, and evaluation). The results showed that complete knowledge was associated with daily functioning among adults with ADHD but not with regulation processes. The predictive power of a model with predictors of metacognition was moderate, which suggests that they can account for significant proportions of the variation in daily functioning for people with ADHD.
Metacognitive Therapy (MCT) is an treatment that focuses on changing metacognitive beliefs that are dysfunctional and perpetuate mental states such as worry, rumination, and attention fixation. Adrian Wells developed MCT based on the model of information processing created by Wells and Gerald Matthews. One case series has demonstrated the effectiveness of MCT in tackling anxiety, best treatment for adhd but it's still a relatively new concept and more research is needed to determine its effectiveness in other disorders.
This study was created to assess the effectiveness of MCT to reduce symptoms of anxiety disorder. However it could be used to treat a variety of disorders and is more effective than any other therapy. It is important to keep in mind that this is not a cure for ADHD however it can be employed as an adjunctive therapy.
Family Therapy
In family therapy, the therapist collaborates with all members of the family. All members can better understand the issues of the client and learn how to help their loved family members. It also assists them in finding ways to deal with their own frustrations and develop healthier communication skills. This type of counseling can be used to tackle comorbid conditions, such as addiction and depression which are frequently associated as part of ADHD.
The therapist will start with an intake session to better understand the family's perspective and determine whether they are appropriate for family intervention. It can be done online or in person. The counselor will explain to each person the nature of treatment as well as the rules for family therapy.
A therapist who has experience treating adults with ADHD asks a lot questions to gain an understanding of their current symptoms, their past, and the impact that they have on their work, family and personal relationships. They will also ask whether there are other mental health issues that are present, such as depression or anxiety.
Cognitive behavioral therapy (CBT) is a structured form of counseling which teaches you to change your negative thoughts patterns and control your behavior. It focuses on boosting self-esteem and self control by educating you on how to cope with stress and anger. This is a short-term solution that can be used alongside other types of psychotherapy.
Individual talk therapy can help those with ADHD deal with emotional trauma from a long-running pattern of underachievement and failure academic struggles as well as frequent job changes and conflict in relationships. It can help you learn stress reduction and coping techniques as well as how to manage your time and finances. It can also help with problems that are comorbid, such as anxiety and mood disorders, which are often seen as a result of ADHD.